What is the standard coinsurance for Major Medical insurance?

The standard coinsurance arrangement for Major Medical insurance is typically set at an 80/20 split. This means that after the insured has satisfied their deductible, the insurance company will cover 80% of the eligible medical expenses, while the insured is responsible for the remaining 20%. This structure is designed to share the financial burden of healthcare costs between the insurer and the insured, incentivizing the insured to engage in cost-effective healthcare decisions while also ensuring that a significant portion of costs is covered by the insurance provider.

The 80/20 coinsurance model allows for a balance between adequate insurance protection and shared responsibility, which can help keep premiums manageable. The insured still has a cost-sharing element, but it allows for substantial insurance coverage.

Other options represent different coinsurance structures, which may not align with the common practices established in Major Medical plans. For example, a 90/10 coinsurance would imply a very high level of coverage with lower out-of-pocket costs for the insured, while a 70/30 model would result in a larger share of costs being borne by the insured. A 50/50 split would suggest an equal burden of costs that is less common for Major Medical insurance, which aims to provide greater coverage to mitigate the risk of